As the American Psychiatric Association (APA) works to revise its Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., parents in California and across the U.S. are wondering what effect the APA's decisions will have on their children and families. Specifically, many are worried that proposed changes in the APA's definition of autism could result in fewer diagnoses of the disorder, and of a resulting inability to receive Social Security Disability or Supplemental Security Income benefits, special education, and medical treatment.
The APA's current revision of the D.S.M. is the first of its kind in nearly 20 years, and as such, will likely affect the diagnosis and treatment of many mental ailments and psychiatric disorders. No proposed changes are creating as many concerns as those regarding autism, however.
Many psychiatrists believe that the current vague criteria for diseases such as autism and Asperger syndrome have led to an influx of diagnoses in recent years. Currently, about one in 100 children is diagnosed with some form of the disorder, with about one million children and adults with autism or a related ailment in the U.S. today.
Under the current criteria, a patient must exhibit at least six of 12 stated behaviors to be diagnosed with an autism spectrum disorder. The proposed changes would require a patient to exhibit at least three deficits in social interaction and communication and at least two repetitive behaviors, in order to be diagnosed which is a much more rigorous test. Without a diagnosis, they will probably be unable to receive SSD benefits and the treatment they need.
In response to the proposed changes, many patient advocates are speaking out. "If clinicians say, 'These kids don't fit the criteria for an autism spectrum diagnosis,' they are not going to get the support and services they need," said Lori Shery of the Asperger Syndrome Education Network, "and they're going to experience failure."
Source: New York Times, "New Definition of Autism Will Exclude Many, Study Suggests," Benedict Carey, Jan. 19, 2012